Investigation of peripheral photoplethysmographic morphology changes induced during a hand-elevation study

Hickey, Michelle J.; Phillips, Justin P.; Kyriacou, Panayiotis A.

doi:10.1007/s10877-015-9761-0

Cited by 40 publications

(37 citation statements)

References 36 publications

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“…However, due to the complexity of the PPG signal and the diversity of usage scenarios for wearable health devices, PPG signal processing is confronted by issues of strong interference and high noise. Researchers 16 , 26 , 27 have carried out a number of studies in this area, verifying that morphological information obtained from PPGs change when different signal-acquisition processes are used. However, there are no comparative studies that examine what the optimal filtering method for PPG signals is.…”

Section: Discussionmentioning

confidence: 92%

An optimal filter for short photoplethysmogram signals

et al. 2018

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A photoplethysmogram (PPG) contains a wealth of cardiovascular system information, and with the development of wearable technology, it has become the basic technique for evaluating cardiovascular health and detecting diseases. However, due to the varying environments in which wearable devices are used and, consequently, their varying susceptibility to noise interference, effective processing of PPG signals is challenging. Thus, the aim of this study was to determine the optimal filter and filter order to be used for PPG signal processing to make the systolic and diastolic waves more salient in the filtered PPG signal using the skewness quality index. Nine types of filters with 10 different orders were used to filter 219 (2.1s) short PPG signals. The signals were divided into three categories by PPG experts according to their noise levels: excellent, acceptable, or unfit. Results show that the Chebyshev II filter can improve the PPG signal quality more effectively than other types of filters and that the optimal order for the Chebyshev II filter is the 4th order.

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Section: Discussionmentioning

confidence: 92%

An optimal filter for short photoplethysmogram signals

et al. 2018

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“…These results can be explained by increased blood vessel resistance shown in pulse area change or decreased maximum blood volume due to vasoconstriction. From a similar viewpoint, significant increase in L sys indicates that contracted vessels might have increased the vascular resistance due to vasoconstriction of the sympathetic nerves (Jaryal et al, 2009; Hickey et al, 2016). TriA, TriA sys , and TriA dia in the area of a triangle where the waveform of the high frequency component such as harmonics was removed showed similar patterns as those of A, A sys , and A dia , respectively.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Pain Assessment Indices Based on Photoplethysmography Waveform Analysis

et al. 2018

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The purpose of this study was to derive parameters that might reflect postoperative pain from photoplethysmography (PPG) and verify the derived parameters in postoperative pain assessment. We obtained preoperative and postoperative PPG and 100-mm visual analog scale (VAS) from 65 surgical patients and extracted a total of 51 PPG morphology-based parameters and their normalized parameters from these PPGs obtained. Pain discrimination performances of these derived parameters were assessed by statistical analyses, including Wilcoxon signed rank test with Bonferroni correction, classification accuracy based on logistic regression, and 4-fold cross validation. After comparing these parameters derived from PPG in pre- and post-operative conditions, statistically significant difference was found in 36 of the 51 parameters. Using logistic classification, dynamic between-pulse parameters such as normalized systolic amplitude variation and normalized diastolic amplitude variation showed better pain classification performance than the static within-pulse parameters. VAS score was 0 in every pre-operation condition, but >60 VAS was observed in the post-operative condition. Systolic peak amplitude variation normalized by PPG AC amplitude showed the best performance in classifying post-operative pain, with accuracy, sensitivity, specificity, and positive predictivity values of 79.5, 74.0, 86.0, and 84.5%, respectively. These results are superior to those of the surgical pleth index (SPI, GE Healthcare, Chicago, IL, United States) at 65.9, 65.9, 66.5, and 66.5%, respectively.

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“…However, it is well documented that this slowly varying component is a carrier of valuable physiological information [ 8 – 10 ] and changes in DC PPG during occlusion of the venous circulation have been reported firstly by Hertzman and Dillon [ 19 ], and later by Almond et al [ 20 ]. Also, there is a growing interest in extracting new information from the PPG signal such as pulsatile pressure, venous oxygenation, or features of the PPG signal that could identify any other haemodynamic parameter different from SpO [ 21 – 24 ]. This paper investigates further the feasibility of estimating relative changes in the concentration of oxygenated, reduced, and total haemoglobin from the DC component of the PPGs acquired from a custom-made, dual-wavelength reflectance sensor.…”

Section: Discussionmentioning

confidence: 99%

Photoplethysmography for blood volumes and oxygenation changes during intermittent vascular occlusions

Abay

Kyriacou

2017

J Clin Monit Comput

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Photoplethysmography (PPG) is an optical technique that measures blood volume variations. The main application of dual-wavelength PPG is pulse oximetry, in which the arterial oxygen saturation (SpO) is calculated noninvasively. However, the PPG waveform contains other significant physiological information that can be used in conjunction to SpO for the assessment of oxygenation and blood volumes changes. This paper investigates the use of near infrared spectroscopy (NIRS) processing techniques for extracting relative concentration changes of oxygenated (HbO), reduced (HHb) and total haemoglobin (tHb) from dual-wavelength PPG signals during intermittent pressure-increasing vascular occlusions. A reflectance PPG sensor was attached on the left forearm of nineteen (n = 19) volunteers, along with a reference NIRS sensor positioned on the same forearm, above the left brachioradialis. The investigation protocol consisted of seven intermittent and pressure-increasing vascular occlusions. Relative changes in haemoglobin concentrations were obtained by applying the modified Beer–Lambert law to PPG signals, while oxygenation changes were estimated by the difference between red and infrared attenuations of DC PPGs (A = A − A) and by the conventional SpO. The HbO, HHb, tHb from the PPG signals indicated significant changes in perfusion induced by either partial and complete occlusions (p < 0.05). The trends in the variables extracted from PPG showed good correlation with the same parameters measured by the reference NIRS monitor. Bland and Altman analysis of agreement between PPG and NIRS showed underestimation of the magnitude of changes by the PPG. A indicated significant changes for occlusion pressures exceeding 20 mmHg (p < 0.05) and correlation with tissue oxygenation changes measured by NIRS, while SpO had significant changes after 40 mmHg (p < 0.05). Relative changes in haemoglobin concentrations can be estimated from PPG signals and they showed a good level of accuracy in the detection of perfusion and oxygenation changes induced by different degrees of intermittent vascular occlusions. These results can open up to new applications of the PPG waveform in the detection of blood volumes and oxygenation changes.

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Investigation of peripheral photoplethysmographic morphology changes induced during a hand-elevation study

Cited by 40 publications

References 36 publications

An optimal filter for short photoplethysmogram signals

An optimal filter for short photoplethysmogram signals

Postoperative Pain Assessment Indices Based on Photoplethysmography Waveform Analysis

Photoplethysmography for blood volumes and oxygenation changes during intermittent vascular occlusions

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